Mold sample mailing instructions - printable instruction sheet

*Mold, Dust, or Particle Single-Sample Chain of Custody Form* & Mailing Instructions Type-into and print this PDF form to send a single sample to our lab - © 1986-2010 Daniel Friedman** Environmental Testing, Paint Analysis, Art Conservation, Forensic Particle Identification, Indoor Air Investigations, Bioaerosols, Pollen, Mold, Mildew, Moisture. Mold Sampling & Laboratory Analysis Mail to: MAIL TO: Daniel Friedman Vassar College Box 419 124 Raymond Avenue Poughkeepsie NY 12604 Six Easy Steps to Get and Mail a Mold Test Kit - http://InspectAPedia.com/sickhouse/bulksamp.htm Printer-friendly Multi-Sample Chain of Custody Form - http://inspectapedia.com/sickhouse/MoldSampleChainofCustody.pdf Printer Friendly Mold, Dust, or Particle Sample Mailing - http://inspectapedia.com/sickhouse/Sample_Mailing_Instructions.pdf
Name
Mailing Address
Telephone (1)
Email (2)
Sampling Address	The identity and address of the building or location from which the samples were collected.
Sampling Area Descriptions	A general description of the building conditions such as evidence of visible mold, leak history, other comments.
Sample Description	More than one sample? use our Chain of Custody Form to number, identify, & describe
Signature & Sample Collection Date / Time	Sign:	Collection Time & Date
Payment	Your check for the lab fee. Lab Fee Schedule and Payment Instructions are below. _ Payment by PayPal - http://inspectapedia.com/sickhouse/bulksamp.htm#PayTo _ Payment by pesonal check or money order payable to Daniel Friedman

Your telephone number for voice contact in the event that we need to call you.
Your email address to receive an emailed-copy of your report. We also mail a printed copy to the mailing address you provide.
As you'll see at our LAB FEE SCHEDULE, the lab fee per individual tape samples of mold or particles is $50. each.
Add $15. to your fee and a telephone fax number if you also need your report to be faxed to a telephone number.

PLEASE DO NOT REQUIRE A RECEIPT SIGNATURE on packages sent to the lab. Failure to follow this suggestion will delay
processing of your sample or may result in the sample being returned to you without processing. If you are using the U.S. Post Office's
Express Mail be sure to check and sign the signature waiver box on the mailing label.

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